title: [Prosthetic humeral head replacement in dislocated humerus multi-fragment fracture in the elderly--an alternative to minimal osteosynthesis?].
abstract: In a prospective randomised study, comprising 30 aged patients with fractures of the proximal humerus (4-fragment fractures according to Neer) minimal osteosynthesis was compared to primary endoprosthetic replacement. The Constant score was used for evaluation during follow-up. After one year the results were similar in both groups. There were two complications necessitating revision surgery among the patients with minimal osteosynthesis and in four cases the implants had to be removed. In the group with primary endoprosthetic repair neither complications nor revision surgery occurred. Primary endoprosthetic replacement for the treatment of proximal humeral fractures appears as a therapeutic option with a low complication rate and a satisfying functional outcome. In older patients we need a safe mode of therapy permitting early mobilization and quick discharge from the hospital back to the patient's home. Endoprosthetic replacement fulfils these demands since it resembles a "one time surgery" without the risk of revision surgery for implant loosening, pseudarthrosis or ischemic necrosis of the humeral head.
authors.affiliation: Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinik Ulm.
authors.forename: I P
authors.initials: IP
authors.lastname: Hoellen
authors.forename: G
authors.initials: G
authors.lastname: Bauer
authors.forename: O
authors.initials: O
authors.lastname: Holbein
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
vernacular_title: Der prothetische Humeruskopfersatz bei der dislozierten Humerusmehrfragmentfraktur des alten Menschen--Eine Alternative zur Minimalosteosynthese?